To identify lifestyle patterns associated with blood lipid levels in children.A representative sample of 2,043 schoolchildren (9-13 years) participated in a cross-sectional epidemiologic study conducted in 77 primary schools in four large regions in Greece. Dietary intakes, breakfast patterns and eating frequency, physical activity levels, sleep duration, anthropometric and physical examination data, biochemical indices and socioeconomic information (collected from parents) were assessed in all children. Principal component analysis was used to identify the lifestyle patterns.A lifestyle pattern of more screen time, shorter sleep duration and higher sugar-sweetened beverage consumption was inversely associated with HDL cholesterol (β = -0.077; P < 0.001) and positively associated with total/HDL cholesterol ratio (β = 0.049; P = 0.025). Furthermore, a lifestyle pattern of more eating occasions and higher moderate-to-vigorous physical activity (MVPA) levels was inversely associated with total cholesterol (β = -0.064; P = 0.006), LDL (low-density lipoprotein) cholesterol (β = -0.065; P = 0.004) and total/HDL (high-density lipoprotein) cholesterol ratio (β = -0.043; P = 0.049) in multivariate models. Finally, children with MVPA levels and eating frequency higher than that corresponding to the second quartile of this lifestyle pattern (i.e., > 44.8 min of MVPA per day and > 4.7 meals per day) were 29.7, 32.6 and 43.1 % less likely of having abnormal levels of total cholesterol, LDL and total/HDL cholesterol ratio, respectively, according to the National Cholesterol Education Program (NCEP) cutoff points.A lifestyle pattern of more than approximately 45 min of MVPA and 5 eating occasions per day was significantly associated with reduced likelihood of dyslipidemias in schoolchildren (9-13 years).